Chapter 5 –The PRM organizations in Europe: structure and activities

European PRM Bodies Alliance

For this paper, the collective authorship name of European PRM Bodies Alliance includes:

European Academy of Rehabilitation Medicine (EARM),
European Society of Physical and Rehabilitation Medicine (ESPRM),
European Union of Medical Specialists PRM Section (UEMS-PRM Section)
European Union of Medical Specialists PRM Board (UEMS-PRM Board)
The Editors of the 3rd edition of the White Book of Physical and Rehabilitation Medicine in Europe: Mauro Zampolini, Pedro Cantista, Maria Gabriella Ceravolo, Nicolas Christodoulou, Alain Delarque, Christoph Gutenbrunner, Carlotte Kiekens, Sasa Moslavac, Enrique Varela-Donoso, Anthony Ward, Stefano Negrini
The contributors: Nicolas Christodoulou, Elena Ilieva, Jorge Lains, Gerold Stucki, Stefano Negrini, Filipe Antunes, Nikolaos Barotsis, Kristian Borg, Quim Chaler, Christoph Gutenbrunner, Črt Marinček, Xanthi Michail, Dominique Perennou, Henk Stam, Ulrich Smolenski, Peter Takač, Aivars Vetra, Jiri Votava, Derick Wade, Daniel Wever, Mauro Zampolini, Hermina Damjan, Calogero Foti, Francesca Gimigliano, Jolanta Kujawa, Alessandro Giustini, Caterina Pistarini, Anthony Ward, Alain Yelnik

Abstract

In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper addresses the structure, organization and activities of PRM bodies in Europe.

Thera are three main bodies, the Section of Physical and Rehabilitation Medicine of the European Union of Medical Specialists (UEMS) very close to the European Union and is committed to define the professional competencies of PRM, the quality management and accreditation and, with the Board, the educational matters. The European Society of Physical and Rehabilitation Medicine (ESPRM) mainly dedicated to promoting research in rehabilitation and create a network of knowledge of PRM across the Europe. The European Academy of Rehabilitation Medicine mainly dedicated to the define the ethical issues in rehabilitation and find strategies for the better educational strategies in rehabilitation.

There are 2 further bodies (the regional fora) aimed to create bridges across the Mediterranean area (Mediterranean Forum of PRM) and across the northern Europe including the eastern countries such as Russia and Ukraine. To support the knowledge, we have in Europe 7 main journals dedicated to the rehabilitation with a growing impact factor.

Last but not least the PRM bodies have an important role across the world with a connection with the International Society of PRM and WHO. The UEMS Section approved motion of international collaboration.

In conclusion, PRM activity in Europe is not limited to the official border but in the network included eastern countries and Mediterranean area. The European extended network is strongly connected with the international PRM bodies, first of all the International Society of PRM.

Key words

Physical and Rehabilitation Medicine, Europe, Scientific Societies, Publications

Introduction

The White Book (WB) of Physical and Rehabilitation Medicine (PRM) in Europe is produced by the 4 European PRM Bodies and constitutes the reference book for PRM physicians in Europe. It has multiple values, including to provide a unifying framework for the European Countries, to inform decision-makers at the European and national level, to offer educational material for PRM trainees and physicians and information about PRM to the medical community, other rehabilitation professionals and the public. The WB states the importance of PRM, that is a primary medical specialty. The contents include definitions and concepts of PRM, why rehabilitation is needed by individuals and society, the fundamentals of PRM, history of PRM specialty, structure and activities of PRM organizations in Europe, knowledge and skills of PRM physicians, the clinical field of competence of PRM, the place of PRM specialty in the healthcare system and society, education and continuous professional development of PRM physicians, specificities and challenges of science and research in PRM and challenges and perspectives for the future of PRM.

The organization of Physical and Rehabilitation Medicine (PRM) Specialty in Europe has been developed in the years to allow on one side to improve the actual practices. on the other to make them uniform in the various European Countries. In this chapter, the activities and programmes of all the European relevant organization are presented. These includes:

the European PRM Bodies. joined for this third edition of the White Book to form the European PRM Bodies Alliance: they include the European Academy of Rehabilitation Medicine. the European Society of PRM and the PRM Section and Board of the European Union of Medical Specialists (UEMS);
The Regional Fora: the Mediterranean Forum of Physical and Rehabilitation Medicine and the Baltic and North Sea Forum of Physical and Rehabilitation Medicine
the National PRM Societies in Europe
the European multinational PRM Journals

Finally, the role of Europe in PRM activities across the world is presented.

European PRM Bodies

The Section of Physical and Rehabilitation Medicine of the European Union of Medical Specialists (UEMS).

Specialty was officially recognised in 1968 when, in Geneva (Switzerland), the World Health Organisation’s Expert Committee on Medical Rehabilitation announced the existence of a new medical discipline: Physical Medicine and Rehabilitation (1,2). Three years later, in 1971, the UEMS approved the creation of a Section under this name. More historical details for the development of PRM and the creation of PRM Section of the UEMS are described in chapter 5 above. Since 2001 the Section was reorganised to serve the multiple needs of the specialty within the European Union (3)(www.euro-prm.org). It was divided in three committees (Figure 1)

The Board (PRM Training and Education Committee)
The Clinical Affairs Committee (for defining and accrediting the quality of clinical care in PRM)
The Professional Practice Committee (for defining and protecting the Field of Competence of the PRM physicians)

The Board and the Training in PRM

Since 1991, the educational affairs of the Section were given to the newly established Européenne College de Médecine Physique et de Réadaptation Fonctionnelle to act as the European Board. according to the provisions of UEMS Specialist training. The route to start training is slightly different in each country, but, despite different entry points to the specialist training programme. the curriculum has much similarity across the continent. The European Board of PRM has the task of harmonising specialist training across Europe, supported by the Basel Declaration and subsequent texts from UEMS (4)and has taken on the following roles:

European examination for recognition of specialist training leading to a fellowship;
Continuing medical education & professional development used for ten-yearly revalidation of fellowship;
Recognition of European trainers & training units through site visits.

The eventual aim of this harmonisation is to produce specialists who can work across European health care systems and allow national medical authorities/employers to recognise the knowledge and expertise of the specialists who have been trained in another part of Europe. All aspects of the Section and Board, including the specialty’s curriculum can be obtained through the Section’s website at www.euro-prm.org.

The Clinical Affairs Committee (CAC) deals with the Quality of Care in PRM

In accordance with the declarations of UEMS (5–7). this committee set up the procedure for European Accreditation of PRM Programs of Care. voted in 2004 (8). Not based on legal obligations or financial advantages. the only goal of this accreditation is to make people throughout Europe aware of the quality of PRM care proposed in Europe and to develop a European PRM culture of quality. The accreditation procedure was first conceived as a simple measure for selecting the programs of care that met a certain number of requirements, particularly organisational requirements. The procedure was based on a questionnaire posted online on the UEMS PRM website. which was then submitted to a five-member international jury. The questions concerned the program’s target population, objectives and scientific bases; the role of the PRM specialist; the means of implementation, the team organisation, and the evaluation of the results. Over the 2-year pilot phase, 13 programs were thus accredited. Following several conclusions from the pilot phase, corrections were done to the questionnaire system which had the advantage of simplicity and the actual description of the program, which rapidly became more important than anything else in forming the opinions of the jury. The ‘‘Programme of care in PRM’’ is the structuring unit for describing the activities of our discipline, the evaluation of its results, and the negotiations for its financing. The programs that have already been accredited. and all the information about the new accreditation procedure. can be found online at www.euro-prm.org.

The Professional Practice Committee (PPC) deals with the fields of competence related to PRM.

The primary objective of the PPC was to insure a single officially-recognised appellation for the PRM specialty in Europe. The expression, ‘‘physical and rehabilitation medicine’’, or a very close equivalent, is officially used in all European countries. Unfortunately, the Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications (9) uses the term. ‘‘physiotherapy’’. At the request of the PPC. UEMS has monitored this issue to make sure that the European Commission adopts the term, ‘‘physical and rehabilitation medicine’’, following the amendment of the old Directive with a new one in 2013 concerning the recognition of the professional qualifications and the names of medical specialties. A new definition of PRM was voted by the UEMS General Assembly in Antalya (Turkey) in October 2003. In addition, thanks to the joint action of the national delegates to the UEMS Council. our Section was able to obtain a vote on an amendment to the European definition of the Medical Act, adding the words, ‘‘functioning’’, ‘‘rehabilitative’’ and ‘‘ethical’’ (10). Under the impetus of the German. Swiss and Austrian delegates. the PRM section of the UEMS decided to encourage the use of the International classification of functioning. disability and health (ICF) in clinical practice (Rennes. France; 30 March 2007). A working group on this subject was constituted in association with European Society of PRM (ESPRM)(11).

As soon as the PPC was created in 2001, its members began writing a second White Book, revising the first White Book about PRM in Europe, which was published in 1989 by three European organisations (the European PRM Federation. the European Academy and the UEMS section and board). The new White Book intended to describe the state of the PRM specialty in all its aspects: title. definition. content and organisation of initial education programs, demographics, continuing education. scientific research and publications. It was co-edited by the PRM Section and European Board and the European Academy of Rehabilitation Medicine in association with the European Society of Physical and Rehabilitation Medicine (ESPRM) and was published jointly by the Journal of Rehabilitation Medicine (12) and Europa Medicophysica (13). This third edition is designed to present the development of PRM in Europe.

Members

Full membership is the 28 European Union members along with Switzerland, Norway and Iceland. Turkey and Serbia are associate members. Several other European countries are observers (Montenegro, Former Yugoslav Republic of Macedonia (FYROM), Bosnia & Herzegovina, Georgia, Russia, Ukraine, Israel). Within all these countries. there are over 23.000 trained specialists and trainees. The UEMS therefore has a major task to make a relevant link between all these countries at a European level. The number of PRM specialists across the countries of Europe varies considerably. The general structure of PRM services across Europe is similar despite the differences between healthcare systems. Proposals for clinical standards are being put together during this process in the form of practice based around health-related groups. Example of this last action are the creation of European Standards of Practice. for patients in post-acute setting. the European card for patients with autonomic dysreflexia as well as the e-book on field of competences part I and part II. the latter is now in progress.

European Society of Physical and Rehabilitation Medicine [ESPRM] (www.esprm.net)

Historical details are presented in chapter 4.

The mission of ESPRM is:

To be the leading scientific European Society for physicians in the field of physical and rehabilitation medicine
To improve the knowledge of fundamentals and the management of activities. participation and contextual factors of people with a disability.
To improve and maintain a strong connection between research and clinical practice in PRM.

The ESPRM has membership from both individual members, who are PRM physicians, or from national PRM societies, Nowadays (2017), the latter are 3436 in number (Austria, Belgium, Bulgaria, Croatia, Cyprus, Denmark, Estonia, Finland, France, Former Yugoslav Republic of Macedonia (FYROM), Georgia, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxemburg, Montenegro, Norway, Portugal, Poland, Bosnia & Herzegovina, Romania, Serbia, Slovenia, Spain, Sweden, Switzerland, The Netherlands, Turkey, Russia, Ukraine), It also has cooperating societies coming from countries out of Europe (Israel, Jordan) or whose structure does not respond to the Statutes and bylaws of ESPRM (Malta).

The following Special Interest Scientific Committees (SISC) have been established: (1) Public Health, (2) Orthotics and Prosthetics, (3) Guidelines, (4) Persons with Pain and Disability, (5) Persons with Parkinson / Movement disorders, (6) Persons with Traumatic Brain Injury, (7) Persons with Musculoskeletal Disorders, (8) Sports Affairs, (9) Robotics in Rehabilitation, (10) PRM in Ageing Persons, (11) Evidence Based Medicine, (12) Persons with Spinal Cord Injury, (13) Persons with Stroke, (14) Ultrasound in PRM and (15) Persons with Peripheral Nerve Disorders. Created during Prague meeting in PRM and (15) Persons with Peripheral Nerve Disorders. August 2016). The following Congresses held by the European Society of Physical and Rehabilitation Medicine. have been the main events at which the activities of the society in the fields of research. were promoted: Vienna 2004. Madrid 2006. Brugges 2008. Venice 2010. Thessalonica 2012. Marseille 2014 and Estoril 2016. Furthermore. the role of the Society is strengthened with regards to its cooperation with other European PRM Bodies (i.e. UEMS PRM Section & Board and European Academy of Rehabilitation Medicine). which work at European level in the Physical and Rehabilitation Medicine field. as well as at worldwide level with the ISPRM (International Society of PRM).

Académie Médicale Européenne de Médecine de Réadaptation / European Academy of Rehabilitation Medicine (EARM)(www.aemr.eu)

The historical details for the Academy are presented in chapter 5.

The mission is

improve all aspects of the rehabilitation of disabled people;
be a reference point in the scientific. educational. and humanitarian aspects of PRM;
engage in moral and ethical debate;
exchange information defining the field of rehabilitation and its terminology;
ensure that education in rehabilitations part of the CV;
support and help improve research in rehabilitation;
introduce and defend the concept of rehabilitation.
and facilitate exchange of PRM trainees and doctors between different countries.

This is made up of a maximum of 50 senior academics doctors from all over Europe and academicians focus on humanities and ethical issues in rehabilitation medicine and in disability. Some works on ethics are:

The ethical problems posed by the longer survival of a greater number of people who are entirely dependent and conscious.
Revealing the prognosis to a paralysed adult.
Ethical problems posed by sexuality for persons with disabilities living in institutional establishments.
Violence and handicap. published as a brief communication. Journal of Rehabilitation Medicine. 2006.
La réadaptation médicale des personnes âgées: défis et challenges humains. éthiques et médico – économiques Commission de Prospectives.

The EARM believes that Rehabilitation is better understood and practised. if there is access to the best information and has launched a series of monographs. These books should be particularly useful for young doctors preparing for the European Board certification in PMR, for senior doctors specialised in PMR and allied disciplines looking for information and continuing medical education as well as for all the members of the rehabilitation team.

Books published in Academy’s Collection by Springer France are:

La Plasticite de la Fonction Motrice / The Plasticity of Motricity Function; by J.P. Didier. Springer. 2004;
Sphincter Functioning / Les fonctions sphinctériennes.by Amarenco G.. Chantraine A. (Eds.) (2006);
Vocational Rehabilitation by Gobelet Charles. Franchignoni Franco (2006);
Rehabilitation and palliation of cancer patients (Patient care) by Hermann Delbruck (2007);
Rethinking physical and rehabilitation Medicine-New technologies induce new learning strategies by Didier. Jean-Pierre. Bigand. Emmanuel (2010);

Moreover. the specially published book under the sponsorship of the Academy “Assessment in Physical Medicine and Rehabilitation: Views and Perspectives” by M. Barat and F. Franchignoni has been edited by Maugeri Foundation Books in 2005. For many years EARM. aiming at encouraging new researchers. has created an annual Academy prize to a publication in the PRM field. (supported in the past by the Swiss Paraplegic Foundation. and the last years by the non-profit Foundation for Rehabilitation Information with the Journal of Rehabilitation Medicine). The prize is officially awarded at the European Congress of Physical and Rehabilitation Medicine.

Regional Fora

The Regional Physical and Rehabilitation Medicine (PRM) Fora:

The Mediterranean Forum of PRM (MFPRM) and the Baltic and North Sea Forum of PRM (BNF-PRM)

In May 1996 was organised the first PRM Mediterranean Congress. in Hersliya. under the slogan “Rehabilitation without frontiers” aiming to promote PRM worldwide and the quality of life of the disabled. namely in the area of the Mediterranean basin. During this congress, a meeting took place under the title: “A Mediterranean PM&R Society, is it viable?” (Turkey) (14,15). It was decided to organise a biennial Mediterranean Congress. The Mediterranean Forum of Physical and Rehabilitation Medicine – MFPRM. – was created at the 3^rd Congress (Athens. 2000) Based on the good experience from the MFPRM a discussion of a Baltic Forum started in 2003 (16). A founder assembly was held in Riga in September 2007 and it was decided to include also the North Sea area into the Forum. It was decided that the Forum would be based on individual memberships. Since March 2010 the Baltic and North Sea Forum on Physical and Medical Rehabilitation – BNF-PRM is registered legally in Latvia. A policy declaration has been adopted by the board in Vilnius in September 2009 (16). and the present organisation has an executive board. an advisory board and four committees. There are two main reasons for the existence of BNF-PRM. The first one is that the Baltic and North Sea is a region with 16 countries having different languages and traditions as well as different health systems leading to differences in approach and strategy for rehabilitation. A second reason for BNF-PRM is the political history of the region. It was divided by the so-called “Iron Curtain” and almost no personal contacts between colleagues living in different sides of the border were possible and consequently there was no scientific communication and exchange.

Obviously. there are basic principles that are common for the MFPRM- and BNF-PRM. The main goals of BNF-PRM and MFPRM are (16,17):

to communicate and exchange knowledge. in the field of Physical and Rehabilitation Medicine;
to create and evaluate concepts for PRM activities and discussing best practice
to stimulate creation of networks for scientific projects. regarding different aspects of Rehabilitation research. multicentre trials and projects;
to support education and training in the field of PRM and facilitate exchange of young doctors and scientists. e.g. organising periodically congresses;
to influence national governments and incorporation of issues of rehabilitation into national health strategies;
to give opportunity for personal contacts;
to have a collaboration and a good cooperation with National and International scientific PRM bodies.

These two Regional Fora extend the PRM culture over the borders of European Community. In the South towards North Africa and West Asia (MFPRM). and in the North over the former “Iron Curtain” including Russia and other countries (BNF-PRM). Both Fora organise scientific congresses (18–21) and summer schools for PRM residents and young specialists. The Euro-Mediterranean PRM School (EMPRMS) – Haim Ring School”. takes place every year in Syracuse with the sponsorship of SIMFER. UEMS. ESPRM and the MFPRM (22). In August 2014. the first Riga Summer School was organised. The “European Journal of PRM”, with the sub-title of “Mediterranean Journal of PRM”, is the MFPRM official journal and the Journal of Rehabilitation Medicine is the official journal of BNF-PRM. The MFPRM website is www.mfprm.org; the BNF-PRM website is www.bnfprm.org (2). The MFPRM and the BNF-PRM are unique and ever growing PRM Societies acting on a volunteer basis to achieve a scientific. cultural and humanitarian mission: to develop and harmonise “Rehabilitation across borders”. These Fora aim to create bridges of understanding and cooperation among Europe and the other countries contributing for better and peaceful regions “without frontiers”.

National PRM Societies in Europe

In Europe. the national societies play a pivotal role in the development of Physical and Rehabilitation Medicine (PRM. The European Bodies exist to support National Societies in their task of developing PRM within their own country’s health economies, professional organisations and academic structures.

Every European country has a national society of Physical and Rehabilitation Medicine with different names and different historical origin. The role of the European Bodies is to harmonise the PRM practice and education across Europe and the national societies, implement of the European standard according with their specific, local, experience.

A problem arises when in a single country there are more than one PRM society and sometimes it is difficult to find the delegates to represent all of them.

Furthermore. the ‘national’ societies are organised differently in the different countries: in some there is one society covering all aspects (ex. The Netherlands). In others, there are different societies (ex Italy. Belgium. France) covering respectively the scientific. professional and synodical matters.

The role of the European Bodies is to harmonize the PRM practice and education across Europe and the national societies, carrying out the implementation of the European standard according with their specific. local. experience.

All the national societies of the member countries have their delegates to the PRM Section and Board of UEMS and participate in the regular general assemblies that are organised twice per year.

Usually in the same week there is the meeting of the delegates of ESPRM where each country expresses a delegate and where there are representatives of all the member of the assembly and individual members.

The European Academy of PRM members are not directly connected to national societies but are involved directly after an individual application evaluated from the Academy.

PRM is recognised as a core service in each of the member states of the Greater European space and the newer associate and observing countries also adopt the same principles.

Most of the national societies (NS) of the specialists in Physical and Rehabilitation Medicine in Europe are members of the European Society of PRM. In fact, one of the goals of the European Federation of Physical Medicine and Rehabilitation that was founded in 1963 was the promotion in each European country of a national PRM scientific society and an organisation to defend the general interests of the PRM specialists. In 2003 when ESPRM was founded as a successor of the European Federation of PRM there were 21 National societies – members. Some of the countries like Latvia and Turkey have more than one National Society of PRM doctors. It is very encouraging and informative about the growing influence of ESPRM that the interest among the NS of joining ESPRM is increasing. In 2015 the Russian and the Ukrainian Societies joined that encompass a large number of “Physiotherapy Doctors” or other related specialization courses with a curriculum different from European Specialisation of PRM. In order to harmonise the specialisation curriculum. they are undergoing transition to the European model of the specialty with the support of UEMS PRM Section and Board.

ESPRM includes not only NS of member states of the European Union. but as it is evident by the list of the members it is including almost all the European countries. I would put this in the ESPRM section

The ESPRM had 17.238 active members from the NS in 2016. The percentage of PRM specialists that are members of their national society varies between the countries. For example, in Germany only 21% of the PRM specialists are members of the German PRM Society, while in Italy this percentage reaches 80% and 95% in the UK. Some of the national societies have also other medical specialists and other professionals as full or associate members – Austria, Czech Republic, Hungary, Ireland, Poland, Russia, Slovakia Republic, UK and Malta,

In Denmark, the PRM is embedded in rheumatology society.

Within the European countries there are 20.655 PRM specialists. The numbers of PRM specialists across Europe varies considerably and table 1 shows the demographic details. The number of PRM specialists per 100 000 inhabitants also varies in the different countries – from 13 (in Croatia) to 0.2 (in Ireland and Malta). (Table 1.)

Interest in the specialty is growing at a European level – the percentage of trainees of the number of PRM specialists varies from 36% in UK to 2% in Russia. This usually depends on the prestige and position of the specialty among the other medical specialties and the rehabilitation needs of the population. Other countries with a higher number of trainees in comparison with the practising PRM specialists are Slovenia – 32%, Norway – 19%, Netherlands -22%, Turkey – 22%, (Table 1).

There are national societies in Europe with very old traditions, founded in the 1920s, like the Romanian Society of Rehabilitation Medicine. Other societies with longer history are the Turkish League against Rheumatism (created in 1947), Austrian Society of Physical Medicine and Rehabilitation (1950), Spanish Society of PRM (1954). There are also younger societies, like that of Ukraine and Malta, founded in 2014. As an old specialty in all the European countries Physical and Rehabilitation Medicine specialists have created their professional and scientific organisations (Table 2).

The main goal of the National PRM societies is to promote the development of Physical and Rehabilitation Medicine and ensure good rehabilitation care to persons with disability and other disabling conditions, to promote the specialty of PRM and the profession of PRM, to develop the Rehabilitation services; the mission and activities of the Societies include propagation of the development of a scientific knowledge regarding rehabilitation, endorsement of scientific research, promotion of education in rehabilitation and popularisation of the idea of comprehensive interdisciplinary rehabilitation for the benefit of those who need it, increasing the expertise of members.

Some of the societies have mainly scientific and educational goals, related to the professional development of the specialists, while others are engaged in defending the professional interests of PRM doctors, defining the competences of PRM doctors, their relations with the other members of the team, with the other medical doctors and other professionals. They focus on creating clinical guidelines, clinical standards of good practice and facilitate the specialty to undertake the required research to develop it further, there are societies that cover all these fields. The national PRM societies organise regular scientific events in PRM – conferences and congresses and are responsible about the continual medical education.

The strength of the societies is that they involve growing number of PRM specialists, devoted to the development of PRM, increased scientific level and activities, very well organised congresses and continual medical education, good cooperation with other national and international societies, institutions, and organisations involved in rehabilitation.

The weakness usually includes low or difficult communication with the government and with financing providers, not enough activities and strength in defending the professional interests of the PRM specialists, and in some countries – low communication with other specialists, not regular number of the active members.

Most NSs issue their own scientific journal. Others, like the Hellenic Society, use the European Journal of PRM, which is the official journal of ESPRM as a National journal. Some of the national journals participate in the European PRM Journals Network that was founded in 2010 with the main goals to create the widest possible readership of the papers published in the European Journals (Table 2).

PRM scientific Activities and their representation in Europe – European PRM Multinational

Journals Scientific journals are key actors of PRM in Europe, since they serve for the development of science and research in our field, Obviously, journals have an international role in what they publish, but in PRM there are at least two main factors that makes the location of a journal crucial. In fact, PRM is “scientifically” young (23), and tradition continues to play a role for treatments, whose evidence is not high, but are nevertheless offered in specific geographical areas (eg some modalities, balneology, spa therapy…). Moreover, in PRM contextual factors play a major role in determining the local therapeutic offer (24,25): while Europe as a whole is different from other continents, still there are differences between north and south, but also west and east Europe. All these may have an impact on European journals.

ESPRM decided some years ago to define the “Core PRM Journals”. according to specific and strict criteria (26,27): in the first 2008 set. 3 European (Journal of Rehabilitation Medicine; Clinical Rehabilitation; Disability and Rehabilitation and 2 American journals have been included; some years later. in 2013. the list expanded to include 2 more European journals (European Journal of Physical and Rehabilitation Medicine; International Journal of Rehabilitation Research). In these years also a European Network of National Journals have been created. but not fully developed (28,29).

All European Bodies have their official Journals. and we will first review them: we will then present the other multinational journals, ie those with interest spread in more than one country. The last years standings of the European Journals in the most important Indexes are listed in Table 3. Their fundamentals are listed in Table 4 and the main contents in Tables 5. Country representation in Table 6.

Annals of Physical and Rehabilitation Medicine (APRM) – Official Journal of UEMS-PRM Section

The Journal is indexed in MEDLIN, Web of Science, and SCImago. Categories of papers include: original clinical, epidemiological and research articles, review articles. editorials and the guidelines. At the discretion of the editor in chief. 20-30% of published papers are immediately put in free access. All papers are in free access at one year. Publications in the Annals of PRM are free of charge.

European Journal of Physical and Rehabilitation Medicine (EJPRM) – Official Journal of ESPRM and UEMS-PRM Section and Board

The Journal is indexed in CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus. Categories of papers include: original articles. systematic reviews and meta-analysis. guidelines. special articles. case reports and letters. It regularly co-publishes Cochrane reviews and a Cochrane Corner since 2007. EJPRM requires authors to follow publishing guidelines (www.equator-network.org).

Areas of interest: clinical papers in all PRM subspecialties (neurological, musculoskeletal, cardiopulmonary, paediatric, general rehabilitation, others). Since 2006 (first among PRM journals worldwide) it gives readers open access. with free-full text accessible online.

Journal of Rehabilitation Medicine (JRM) – Official Journal of UEMS-PRM Board and EARM

The Journal is indexed in MEDLINE. PubMed Categories of papers include: original articles, reviews, case reports, short communications, short reports and letters. Areas of interest: functional assessment and intervention studies, clinical studies in various patient groups, methodology in PRM, epidemiological studies on disabling studies and reports on vocational and sociomedical aspects of rehabilitation. From 2017 JRM will be a completely online journal with immediate open access from the actual open access after 6 months.

Clinical Rehabilitation (CR)

The Journal is indexed (among the others) by ASSIA, CINAHL, Current Contents / Clinical Medicine, EMCare, MEDLINE, PsycINFO, Science Citation Index, Scopus. Categories of papers include: original papers. systematic reviews. Rehabilitation in Practice articles correspondence relating to published papers and short reports. Areas of interest include: goal setting, describing interventions. evidence base for rehabilitation, theoretical base for rehabilitation. the editor always considers whether a paper is relevant to a practicing clinician. of any profession. It covers functional disorders. all ages, every intervention and all methods. Open access is available on payment of a fee.

International Journal of Rehabilitation Research

The Journal is indexed in PubMed/MEDLINE. Science Citation Index Expanded. Social Sciences Citation Index, Current Contents (Social & Behavioural Sciences and Clinical Medicine), Scopus, SCImago, Engineering information and PsycINFO. It is a member of the Committee on Publication Ethics (COPE) which aims to define best practice in the ethics of scientific publishing (www.publicationethics.org). Categories of papers include: original articles, review articles, brief reports, case reports and letters. Areas of interest: functioning and disablement throughout the life cycle; rehabilitation programs for persons with physical, sensory, mental, and developmental disabilities; measurement of functioning and disability; special education and vocational rehabilitation; equipment, access and transportation; information technology; independent living; consumer, legal, economic and socio-political aspects of functioning, disability and contextual factors. The Journal is available through individual and institutional subscription, and accessible online through Ovid at institutions worldwide.

Physikalische Medisin – Rehabilitationsmedisin – Kurortmedisin – Journal of Physical and Rehabilitation Medicine (JPRM)

The journal is indexed in Scopus and Science Citation Index Expanded, Categories of papers include: original research, clinical case reports and reviews, guidelines and educational articles, CME material, congress abstracts, society news, editorial material and summaries of the latest research. Areas of interest: scientific and educational articles both in physical medicine and rehabilitation Reviewed and accepted articles are published online ahead of print to ensure rapid dissemination of knowledge.

Rehabilitación (Madr.) (RM)

The Journal is indexed in Eventline, Bibliomed, Sedbase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Pascal and Indice Bibliográfico Español en Ciencias de la Salud (IBECS), Categories of papers include: original articles, reviews, case reports, letters to the editor, special articles and editorials, its main goal is to provide evidence basis to improve interdisciplinary rehabilitation care. Thus, the scope of the journal includes clinical and basic research papers on rehabilitation field that may improve knowledge and skills of the readership (physiatrists, physical therapists, occupational therapists and other allied health professionals). The journal is mailed to all SERMEF members (which is more than 1,700 professionals). At this moment, it is not Open access but for some specific articles.

Disability and Rehabilitation

Disability and Rehabilitation and Disability along with Rehabilitation: Assistive Technology are international multidisciplinary journals which seek to encourage a better understanding of all aspects of disability and to promote rehabilitation science, practice and policy aspects of the rehabilitation process, Disability and Rehabilitation publishes Reviews, Research Papers, along with sections on Rehabilitation in Practice, Perspectives in Rehabilitation and Case Studies along with occasional Letters, Papers focused on assistive technology are especially appropriate for Disability and Rehabilitation: Assistive Technology, Submissions covering a wide range of topics on disability and rehabilitation from researchers and practitioners across all disciplines working in the field are encouraged. The journals welcome both quantitative and qualitative research along with multidisciplinary perspectives to embrace a wide range of professionals. Both journals also publish peer-reviewed special issues as appropriate.

The role of Europe in PRM activities across the world

The umbrella organisation of PRM physicians worldwide is the International Society of Physical and Rehabilitation Medicine (ISPRM) (30).

ISPRM has three mandates: a humanitarian or civil societal, a professional one, and a scientific one. (31,32) To achieve its goals ISPRM relies first on its memberships which includes members of national societies, including all European PRM societies as well as individual members, In addition, ISPRM collaborates with regional bodies, including in Europe the European Academy of Rehabilitation Medicine (EARM), the European Society of Physical and Rehabilitation Medicine (ESPRM) and the Physical and Rehabilitation Medicine Section of the European Union of Medical Specialists – (UEMS-PRM), Section and Board through mutual recognition agreement and a joint work plan. Outside the field of PRM, ISPRM is collaborating with other NGOs and most importantly with World Health Organisation (WHO) (Fig. 2) (32).

An important role is played from the regional fora: The North and Baltic Forum of PRM that include the nearby regions in north Europe Such as Russia, Ukraine and The Mediterranean Forum of PRM that include all Mediterranean basin regions.

The basis of the official relationship with WHO is a mutually agreed three-year plan for collaboration, for which once every three years the WHO Executive Board reviews the results, most important current topics of the collaboration work plan include the system-wide implementation of the International Classification of Functioning, Disabilities and Health (ICF) in PRM, rehabilitation and health care systems at large. The establishing of learning health system across countries worldwide exemplified for the situation of persons living with Spinal Cord Injury (33) and the strengthening of rehabilitation services worldwide (34). Significant contributions of Europe in the context of the current work plan is the development of National Rehabilitation Quality Management Systems (35) including the specification of rehabilitation services applying ICSO-R (36), Clinical Assessment Schedules (37), the European-wide implementation of culturally adopted versions of the clinical assessment schedules tool (35,38,39) and the development of metrics for the standardised reporting of data collected with a range of data collection tools (35,40,41)(6, 11-13). Most importantly, the UEMS PRM section and board is developing reference rehabilitation services committing themselves to provide onsite advise and demonstration to PRM physicians and health care organisations worldwide. Within the context of our specialty, that is in the context of the internal policy agenda of PRM, the European bodies and national societies are involved in the further development of the scientific congress topics list as core element of building the identity and core competencies or PRM. In addition, 8 journals are active members of ISPRM web of Journal (Table 7) (1).

A most important initiative by the PRM bodies in Europe is the development of a Cochrane field in rehabilitation medicine (42–44). (refer to chapter 11 for the details)

Figure 2. Pathways of political influence on the World Health Organisation (WHO) by a non-governmental organisation (NGO) in official relation. CST: Classification. Terminology and Standards; DAR: Disability and Rehabilitation; ISPRM: International Society of Physical and Rehabilitation Medicine.

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